Surgical sutures are commonly used in a wide variety of surgical procedures. Typically, the sutures are packaged within individual containers such as foil laminate packages. These packages are substantially flat or planar, and multiple individual packages are stacked on one another and provided together in a larger package of “box” to the customer. At the surgical site where the sutures are used, the larger package is typically designed to also serve as a dispenser that provides a means for easily dispensing the smaller packages when needed. The United States and Europe have developed different preferences for how the individual suture packages are dispensed. In the United States, it is preferred to have the smaller suture packages stacked on one another horizontally as shown in FIG. 1a. An opening 10 is provided in the dispensing box 11 so that the suture packages 12 can be removed from the dispensing box by grasping the shorter edge 13 of the bottom most suture package, and withdrawing it out through the opening in the direction shown by the arrow. As this is the preference in the U.S., racks that hold multiple dispensing boxes have been designed specifically to hold the dispensing boxes in the vertical configuration shown.
To the contrary, in Europe the preference is that the dispensing box 15 be positioned horizontally as shown in FIG. 1b so that the dispensing box can be used like a drawer. Often, the dispensing box consists of an outer casing 16 and a drawer 17 that can be slid out from the casing in the direction indicated by arrow a in FIG. 1b. The suture packages are stacked vertically on a long edge 18, and are removed in the direction indicated by arrow b. Based on this preference, European racks have also been designed specifically to hold dispensing boxes in this manner.
In an effort to provide a suture dispensing box that satisfies both the U.S. and European preferences, U.S. Pat. No. 5,860,517 describes a two-piece dispensing box that includes a drawer that slides within a sleeve or outer casing, where the box further includes an opening that enables dispensing according to the U.S. preference. This design, however, it not entirely universal, as additional spacers are required within the package to ensure a proper fit in both the U.S. and European racks. Since U.S. racks are deeper, the package described in the '517 patent, if sized for a European rack, would sit back too far in a U.S. rack. To address this, the package includes a drawer dimensioned for a European rack in combination with a sleeve dimensioned for a U.S. rack. The open space within the oversized sleeve is filled with a spacer. Thus, the device disclosed by the '517 patent requires a two-piece configuration in combination with the extra spacer that serves no other useful purpose.
Most known surgical dispensing boxes are also made of paperboard. Paperboard must be stamped out in two dimensions, then subsequently folded and erected, requiring separate machinery and automation for the latter. This process typically results in waste of approximately 7-10% due to boxes that are crushed or damaged. Further, since folding does not yield a tight fit of corners and/or sides, paperboard boxes often must be delivered in a cellophane wrapper in order to minimize dust or other particulates from entering the package. Finally, as will be described further below, product tampering and counterfeiting issues are difficult problems facing the industry today. Paperboard boxes have proven less than optimal in dealing with these problems. Although suture dispensing boxes have been known to be formed from molded plastic, none are known to satisfy the need for a universal dispensing box, and all have required multiple moving parts to accomplish dispensing needs.